CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Sweeny Community Hospital

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $104
Cash Discount Price: $91
vs. Medicare Baseline: 1.37x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Sweeny Community Hospital is $104. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $91. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 1.37x the Medicare baseline. Located in 305 North McKinney, Sweeny, TX.

Cash / Self-Pay

$91

Average discount available for prompt cash payment at this facility.

Insurance Median

$104

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$76.15

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $76.15 (100%)

Cash / Self-Pay: $91 (120%)

Insurance Median: $104 (137%)

Cash: $91 (120% of Medicare)

Ins. Median: $104 (137% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $76.15 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Blue Cross Blue Shield	$35 - $116	46%
Evercare Mcaid	$58 - $116	76%
UnitedHealthcare	$62 - $186	81%
Aetna	$67 - $186	88%
Amerigroup Mcr Adv - All Other Plans	$67 - $135	88%
Community Hlth Choice Him - All Other Plans	$67 - $135	88%
Coventry Mcr Adv	$67 - $135	88%
Molina Mcr Adv - All Other Plans	$67 - $135	88%
Superior Hp Mcr Adv-All Other Plans	$67 - $135	88%
Wellcare Mcare - All Plans	$67 - $135	88%
Care Improvement Mcr - All Plans	$68 - $136	89%
Choicecare Mcr Adv - All Plans	$68 - $136	89%
Amerigroup Mcaid	$80	105%
Community Hlth Choice Star	$81 - $164	106%
Molina Mcaid	$81 - $164	106%
Superior Hp Mcaid	$81 - $164	106%
Tx Chlidrens Hp Mcaid - All Plans	$81 - $164	106%
Tx True Choice Mcaid - All Plans	$81 - $164	106%
Beech Street - All Plans	$86 - $175	113%
Community Care Network - All Plans	$92 - $186	121%
Galaxy Health Network - All Plans	$104 - $209	137%
Multiplan - All Plans	$104 - $209	137%
Evercare Mcr Adv - All Other Plans	$112 - $226	147%
Cigna	$120	158%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $91.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 92507.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Sweeny Community Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 92507.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.